If elected, Democratic presidential candidate Barack Obama will move quickly to reform the American health care system, Sen. Sheldon Whitehouse, D-R.I. told a group of almost 50 Dartmouth Medical School students and Dartmouth-Hitchcock Medical Center employees Wednesday afternoon in the Rockefeller Center. Obama's Republican opponent, John McCain, would damage it further, Whitehouse added.
Whitehouse focused his remarks on the candidates' health-care proposals and said that three of Obama's proposals to immediately reform health care would save money.
The first step, and one that Whitehouse believes is particularly important, would be to invest in Electronic Health Information Technology Systems and put health care records online. Whitehouse cited a Rand Corporation study that found that the adoption of electronic health records in hospitals and doctors offices could save up to $77 billion.
"Everybody would have a secure, private electronic health record," he said, referring to the shape an ideal health care system would take. "Those records would be linked so that you could do a good deal of your health care work off your computer, set up appointments with your doctor, talk to nurses, discuss lab tests ... all those sorts of things could be done online instead of waiting in line at the doctor's office."
Obama's proposal also includes paying regional health care systems for the quality of care they provide, Whitehouse said. Both Whitehouse and medical students in the audience pointed out that public and private insurers currently tend to pay providers based on the volume of services provided, which can affect the quality of patient care.
The third step would reform the way doctors are reimbursed, Whitehouse said, because under the current system, savings -- like those described in the Rand study -- are only beneficial to insurance companies.
"There would be a nationwide infrastructure of quality organizations, exploring all the ways in which improving quality of delivery saves money and saves lives, so you see hospital acquired infections disappearing, you would see an industry of prevention of illness appearing as it became economically sensible to invest in prevention," Whitehouse said, explaining additional components Obama's health-care system. "I think you would see the medical community paid more for results and healthy outcomes than for individual procedures."
The health-care workers and medical students in the audience asked Whitehouse details regarding Obama's health-care plans, but in some cases, Whitehouse said he could not speak for Obama and discussed his own opinions with the audience.
When asked why Obama was not proposing single-payer health care, Whitehouse replied that while he would personally like to see a single-payer program, the current system and political climate are not conducive to "attacking the insurance companies head-on." He said that too many powerful legislators had been involved in the failed 1993 attempt at universal health care, and that those senators believed it was better to "move gradually and outflank the insurance companies."
Whitehouse also discussed his personal passion for expanding palliative care, an issue he said he has not yet discussed with Obama. Whitehouse, who is in his second year as a senator, hopes to promote palliative care, which eases the suffering of terminally ill patients without prolonging their lives unnaturally. He said a shift towards encouraging doctors to discuss palliative options with patients would save Medicare money.
Whitehouse compared one aspect of McCain's health care plan to credit card companies that charge "penalties and fees" to their customers. According to Whitehouse, the McCain plan allows insurance buyers to move between states which mirrors credit card regulations that allow credit card companies to move to states with the lowest levels of consumer protections, and then exploit credit seekers across the country.
"Senator McCain's [health care] plan would leave people on their own, struggling to buy health insurance, trying to buy $12,000 health insurance for $5,000," Whitehouse said.
The discussion with Whitehouse was not advertised to Dartmouth undergraduate students. According to Sandra Abrevaya, communications director for the Obama campaign in New Hampshire, the campaign tries to balance large rallies with more intimate events in which people have a chance to ask substantive questions.
"The Obama campaign is really stressing health care in New Hampshire, because there really are big differences in the health care policies of each candidate," Abrevaya said. "You have one individual who says preexisting conditions will not affect coverage and you have one that will let them. You have one individual with a health care plan that would cover the uninsured and you have Senator McCain who plans on taxing health care for the first time in history."
